Angioplasty vs. Bypass continued...

Patients treated with bare-metal stents were nearly six times as likely to
need a repeat procedure to reopen the affected vessel than those who underwent
bypass surgery.

Patients treated with drug-coated stents were about three times as likely
to need a repeat procedure.

The next step is a clinical trial pitting bypass against angioplasty with
drug-coated stents in patients with left main artery disease, Park says.

Bypass Still Treatment of Choice

Doctors are enthusiastic about the findings but stress that, for now, bypass
surgery remains the treatment of choice for these patients.

"As you push a catheter through to the left main coronary artery, you're
temporarily occluding most of the heart's blood supply," says American
Heart Association spokesman Vincent Bufalino, MD, of Midwest Heart Specialists
in Naperville, Ill. "The risks to the patients are considerable."

In the long term, there is also a risk of artery reclosure, or restenosis,
even months or years after angioplasty, Bufalino tells WebMD. "If you're
talking about the left main coronary artery suddenly reclosing, that could be a
significant problem."

Patrick Serruys, MD, a professor of interventional cardiology at Erasmus
University in the Netherlands, says that "many places in the world are now
gaining quite acceptable results" using angioplasty in patients with left
main coronary artery disease.

"But there's a long way to go before we can change clinical
practice."

Cleveland Clinic's E. Murat Tuzcu, MD, moderator of a news conference that
discussed the findings, says, "Left main [artery] disease has always been
thought of as a surgeon's land. If confirmed in future studies, the
implications are tremendous."